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Enter all previous work sites that apply after March 1, 2020

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Example: Hospitalist, Family Medicine (Face to Face), Family Medicine Virtual Care, Anesthesiology, Internal Medicine, ICU Support, Emergency Department

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Please indicate whether you have been in contact with or treated known/suspected COVID-19 patients without all appropriate PPE and IPAC practices in place?  Essentially, have you been identified as a “close contact” by Public Health or your hospital’s Occupational Health?